The Upper Pole

Abstract

Reconstruction of the upper pole of the ear requires adequate evaluation and preoperative surgical planning because reconstructing a segment of an ear is extremely difficult. The segment of the superior part of the ear may be missing because of acquired or congenital deformities or skin cancer resection. Each patient presents with individual deformities that require a precise approach to achieve a good balance of the ear and facial contour. Surgical reparation may be performed in one or two surgical stages. To perform it in a single operation one must create chondrocutaneous advancement composite flaps or include a cartilage graft to support the helical cutaneous flap. However, sometimes two stages of operation are necessary. In such circumstances, it is essential to add a new auricular framework, sculpturing it by excavation of the rib cartilage. It is embedded through a subcutaneous tunnel undermined on the temporal region following the surgical planning. Therefore, the new segment of the missing part of the amputated ear is created by cartilage graft. During the second surgical stage the upper segment of the ear is lifted from the temporal area and a skin graft is performed on the posterior aspect of the new ear to cover the raw area.